Concorde Lift (DePuy Synthes), a new expandable interbody device, is launching in the USA. The implant is designed to treat patients suffering from degenerative disc disease as part of the new offering called UNLEASH MIS TLIF (Transforaminal Lumbar Interbody Fusion) procedural solution. A company press release states that this system helps simplify key stages of TLIF surgery by improving efficiency.

During spinal fusion surgery, the degenerated disc is removed and the Concorde Lift expandable interbody device is implanted in its place to help restore the disc height between the two vertebrae in the spine.

“I have had the privilege of performing one of the first cases of spinal fusion surgery using the Concorde Lift implant in the USA and have been very happy with what I have been able to achieve using this device,” says John Hall, Spine and Orthopaedic Trauma Surgeon (Flagstaff Bone & Joint, Flagstaff, USA). “I believe that being able to access the disc through a small space and then controllably expanding the cage to fill the disc space allowed me to achieve a reliable fusion.”

By 2020, it is estimated that half of all spinal fusion procedures will be performed using a minimally invasive approach. While it has a steep learning curve, minimally invasive spine surgery has been associated with reducing complications, blood loss, muscular damage and pain, and has a faster recovery for patients compared to conventional open spine surgery.

This MIS TLIF procedural solution includes the Concorde clear MIS discectomy device and the VIPER PRIME System for percutaneous pedicle screw insertion. Here are the steps involved in the procedure:

The Concorde Lift expandable interbody device is inserted once the disc has been cleared. The surgeon can expand the cage to fit the individual patient’s anatomy (as opposed to using pre-set levels). The instrumentation provides tactile feedback during the expansion manoeuvre, and the system offers surgeons the option to back-fill the space with bone graft after the cage has been fully expanded.

The VIPER PRIME System combines multiple instruments into one screw inserter tool, enabling the surgeon to perform percutaneous pedicle screw insertion in a single instrument pass.

In an anatomic lab study, this MIS TLIF Solution suggested a potential reduction in instrument passes and showed a reduction in procedure time during disc removal, cage implantation and screw placement compared to a control group of current product offerings. Based on the early indications of this cadaveric study, DePuy Synthes is investing in a health economic study in addition to a clinical study to evaluate the potential benefits of the UNLEASH MIS TLIF procedural solution as compared to traditional MIS TLIF procedures.